This application relates to a surgical instrument that is relatively easy to use for performing laparoscopic or other internal surgical procedures.
One of the newest types of surgical procedures is laparoscopic surgery. In such procedures, Several small incisions are made in a patient. A scope is inserted through one of those incisions and monitors the surgery. Surgical tools are inserted through the other incisions. By inserting a scope within the patient to monitor the surgical area, the surgeon is able to perform the surgery without actually making the otherwise necessary large incision to provide access to the area of the surgery.
In one common laparoscopic surgical procedure, CO.sub.2 gas is inserted into the patient's abdomen to inflate the abdomen and create a space for the scope to be able to view the area to be treated in the surgery. Since the gas is required to inflate the abdomen, it is also necessary that each of the incisions for the surgical tools be sealed against air leakage. Thus, sheathes are typically inserted through each incision, and the surgical tools are slid within the sheath and into the patient. The surgeon monitors the surgery on a video screen by watching a video provided by the internal scope. Surgical tools extend into the patient and perform the surgery remotely, with the surgeon being guided by the video.
The use of such surgery has a great potential for many surgical procedures. The small incisions are much less stressful on the patient than the otherwise required large incisions. Until this time, however, laparoscopic surgery has been limited to certain relatively simple procedures. The reason for this perceived limitation is that many otherwise simple surgical steps become very difficult and time consuming when done with laparoscopic surgical instruments.
As one major example, suturing tissue with standard laparoscopic surgical tools is very complex. The surgeon must insert a surgical tool holding the suture needle and suture through a sheath into the patient, then grip the suturing needle with a gripping tool inserted through the same or a second sheath, and then perform the procedure of inserting the suture needle through the tissue to be sutured, and tying off the suture. The process of suturing tissue alone is enough to fatigue a surgeon. For this reason, only relatively simple surgical procedures have been adapted to laparoscopic techniques. It would, of course, be desirable to reduce the complexity of the standard surgical steps such as suturing to allow more complex surgical procedures to be performed with laparoscopic surgery techniques.
In addition, since the surgical tool must extend through the sheath, the surgical tools are typically in a relatively predefined angular orientation within the patient. It would be desirable to provide a surgical instrument which is universally adjustable relative to the barrel of the surgical instrument about any angle, and three dimensionally. In the past, laparoscopic surgical tools have only provided limited adjustment in a single two dimensional plane.